Has anyone used SpaceOAR gel?

User

Posted 08 Jan 2019 at 10:47

I'm due to start my RT on 11th Feb, and when I was speaking to my oncologist yesterday evening I asked him about the use of SpaceOAR gel, a "spacer" which is injected between the prostate and the bowel to reduce the chance of long-term radiation damage to the bowel. He said that the hospital I'm having my treatment at (Clatterbridge Cancer Centre on the Wirral) didn't currently use it, although they were considering doing so soon. He said, though, that he thought it was a useful treatment and that he'd be happy to arrange for me to have it elsewhere if I wanted to.

I've contacted my insurance company this morning (I have private medical insurance through my work), and somewhat to my surprise they've said they'd be happy to cover the cost of the procedure, so the way is open for me to have it if I want to.

I was wondering what peoples' thoughts were on this. Has anyone had it done? How "major" a procedure is it? Any side-effects?

Any opinions would be very welcome!

Cheers,

Chris

User

Posted 26 Feb 2019 at 22:09

If Space OAR beneficially provides greater separation between Prostate and Rectum where RT is to be given, I wonder whether there are situations where it would help with other forms of treatment? I was told that further HIFU would not be given to me because my small tumour was too close to the rectum which could suffer collateral damage. Alternatively, it might help with Focal Laser Ablation (FLA). I will be writing to an expert on Focal Therapy this week to discuss this possibility and will post elsewhere as this may be of interest to others but I don't wish to side track this thread.

Barry

User

Posted 14 Mar 2019 at 08:34

A "burning" sensation while peeing is an extremely common side-effect of RT and is basically caused by the radiation irritating the bladder. You may find that cutting out caffeine helps.

Hope your treatment continues to go well. I've now completed 22 out of 32 fractions and, touch wood, no sign of any diarrhoea thus far.

Cheers,

Chris

User

Posted 16 Mar 2019 at 17:01

Glad to hear you’re doing so well. My nighttime situation has improved, I’m happy to say. I only had to get up twice last night, which is a great improvement!

All the best,

Chris

User

Posted 13 Apr 2019 at 14:26

One day, this will be available to everyone and people will be horrified that men used to have RT without it.

The exercise class sounds brilliant. Physios are underrated when it comes to men with prostate cancer / recovering from PCa treatment.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 26 May 2019 at 17:48

You had RP, though, Rob, not RT. The radiology team at the hospital where I had my RT recommended cranberry juice and it worked wonders for me.

Cheers,

Chris

User

Posted 17 Nov 2019 at 20:05

I was diagnosed with PC in Feb 2019 with a Gleason score of 3+4 and 4+3 so 7. My understanding is that this is one above monitor only. My London-based specialist was quite visibly and verbally annoyed when I declined the scalpel. This hospital was listed as one of the world’s top 100 in The Times recently.

I progressed with Prostat injections, but part way through became aware of SpaceOAR and the benefits described in the NICE report. My specialist agreed he would seek to have the procedure in my situation but it was not available at this London teaching hospital. I have now had my 6th Prostat injection, which should be the last before RT, but I am still awaiting referral to a different London hospital for consideration of the hydrogel under NHS.

Given the benefits reported by NICE and the comments here (thank you), I am very upset that a so-called ‘top 100 world hospital’ has senior clinicians that are so dismissive of SpaceOAR. Surgeons like using the scalpel!

Hopefully, I will get a new referral soon as the first hospital has now ‘taken me off the system’. My advice gents (and ladies carers) is be firm and insist on the best treatment available.

Good luck and best wishes.

User

Posted 20 Jan 2020 at 21:59

I was diagnosed on the NHS in September 2019, Gleason 9, so aggressive. Fortunately my wife has Aviva Private Health Insurance through her work which covers me too. My oncologist in Glasgow arranged for me to have a PSMA scan done at the Harley St Clinic, basically an MRI scan with a special radioactive tracer for high imagery to double check cancer has not spread outside the prostate. It had not fortunately. I mentioned at the next appointment that I had read about SpaceOAR and it turned out that he is leading the cause to get it approved on the NHS in Scotland and said he would arrange for this to be done again by the Harley Street Group. I would be the first person he had arranged this for. My insurance company authorised the PSMA scan and the spacer and have been excellent. I had the fiducial markers and SpaceOAR done at the same time under general anaesthetic at the Princess Grace Hospital in London on Tuesday 14th Jan 2020, it all went to plan and I was discharged that afternoon. No pain, bruising or discomfort, I don’t even know it is there and went for a couple of pints that night! My RT planning day is this Thursday and I start 20 sessions of RT on 10th February at the Beatson Cancer Centre in Glasgow. I will update here how it goes and what the side affects are like. I am hoping the spacer does its job well! Getting there, just counting down the days now to 9th March when the RT ends. Oh, and I have been on hormones, bicalutamide, since 10th October and will remain on it for two years because of the Gleason score of 9.

Good luck to all!

Edited by member 20 Jan 2020 at 22:01 | Reason: Not specified

User

Posted 06 Feb 2020 at 15:22

Hi Russell,

My SpaceOAR was done (privately) under GA at Wycombe General NHS hospital. Don’t know if that helps you at all.

User

Posted 06 Feb 2020 at 16:34

To be honest, it's not something I'd spend my own money on. The modern EBRT machine deliver a very targeted radiation dose, and I had minimal bowel problems during (or after) my RT.

Cheers,

Chris

User

Posted 06 Feb 2020 at 16:52

Its not just to prevent the immediate side affects it’s also there to protect the bowel from the potential long term damage from radiotherapy which can occurs years after the treatment.
Will let you know how the immediate side affects go, first RT this Monday coming. I can start my countdown from 20 - 0 then. Cheers

Edited by member 06 Feb 2020 at 17:16 | Reason: Additional info

User

Posted 07 Oct 2021 at 14:22

Good to hear you are doing well Arthur! I finished my RT 2 weeks before first lockdown in March 2020 and stopped taking Bicalutamide last month on 12th September. My last 4 PSA tests have been undetectable so the next one is due in January 2022 and we will see what effect ending the hormone tabs has. As I was diagnosed Gleason 9, and got the RT done and dusted before Covid, I like you, feel quite ‘lucky’, although even after being double jabbed, I contracted Covid last month. Fairly mild symptoms but boy do I get tired every afternoon now! Now thinking about retirement in the next 2 - 3 years. I’m 61 and have worked since I was 16, so think I’m about ready to give it up. All the best - onwards and upwards!

User

Posted 17 Oct 2021 at 21:48

Not necessarily correct although that may have been good advice in your particular case. Whether a man should have a full or partially full bladder depends on his own internal plumbing plus whether the oncologist needs to get the bottom of the bladder into the treatment field. Fullness of the bladder doesn’t affect the bowel; reducing impact on the bowel is helped by a) the bowel being empty of faeces and gas and b) the cancer not being at the front of the prostate.

Suggest you amend your post; it is against the site rules to name your medics.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 18 Oct 2021 at 00:31

Apologies, I think it is just what we each mean by 'bowel' - probably clearer to refer to the small intestine, large intestine or colon and the rectum. SpaceOar sits between the prostate and the rectum, rather than the prostate and the small intestine - a full bladder doesn't protect the colon or rectum.

A full bladder can lift the small intestine up out of the area, which protects it, but the main reason for a full bladder is that it ensures consistent position of the prostate - it also lifts the bladder out of zone, reducing bladder side effects. Whether the bladder needs to be full or partially full, the importance of it being consistent for each fraction is that it holds the prostate in exactly the same position day after day. My husband didn't need a full bladder - he was just asked to drink water 10 minutes before the session because they needed to get the bottom of his bladder into the RT field as that was where the rogue cancer cells had spread to.

In the UK, we are seeing some hospitals opting for empty bladder instead - again, to ensure consistency for each fraction.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 07 Nov 2021 at 09:50

Welcome to the SpaceOAR “club” Jono! All being well your planning scan(s) will reveal just how much extra space has been created in that all important place, where as I understand it there normally is none or almost none. Did you have it done under general or local anaesthetic? I do hope your Onco is as happy with the “placement” as mine was, it really boosts the spirits to see a senior medic so cheerful at this stage. Wishing you all the best for the weeks to come.

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User

Posted 08 Jan 2019 at 13:43

I see that this treatment is reckoned to have beneficial effects by NICE:

https://www.nice.org.uk/guidance/IPG590/chapter/1-Recommendations

Chris

User

Posted 08 Jan 2019 at 15:01

I talked to an oncologist about it, should I have a recurrence and undergo RT, but he said as I haven’t got a prostate anymore, it’s not appropriate.

I looked it up when Matron first mentioned it early last year and it seems very good. I would definitely have one fitted/installed.

Best of luck with your RT.

Cheers, John.

User

Posted 08 Jan 2019 at 19:58

Hi CC, I have booted the relevant previous post up the 'recent conversations' list for your information.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 08 Jan 2019 at 21:02

Cheers, Lyn. I definitely think I'll go for it, assuming it can be done in time for the start of my RT. My oncologist reckons the place he knows it can be done is in Northern Ireland, but that's an easy trip for me, and by the sound of it I could do it as a day trip or at most an overnight one.

User

Posted 08 Jan 2019 at 23:09

Not sure why, but I have Liverpool lurking in my memory bank as a hospital that does it? There is also a map of provision (private) here

https://www.genesiscare.com/uk/treatment/cancer/radiotherapy/space-oar-hydrogel/

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 10 Jan 2019 at 18:37

I spoke to my oncologist's secretary today, and she told me that my oncologist knows of a chap in Leeds who can do the procedure, and is contacting him to try to sort it out for me. I only have a 10-day "window" between returning from holiday and starting RT, so I'm hoping it can be done during that time.

Leeds is only about an hour away from me, so that would be perfect if it can be arranged. Keeping my fingers crossed!

Chris

User

Posted 10 Jan 2019 at 18:50

Ooooh, I wonder if it is our Mr B?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 11 Jan 2019 at 08:21

It is indeed!

Chris

User

Posted 11 Jan 2019 at 13:37

Drat. Mr B. has got back to my oncologist to say that Leeds no longer offers the treatment, because the logistical issues aren't worth the hassle for the once in a blue moon that the procedure is requested. He doesn't know anywhere nearer than London who does offer it, and it would delay my RT to search further for it, so I've decided (regretfully) to forego the procedure and just have the "normal" RT as planned. My oncologist assured me that with modern "intensity modulated" RT the risk of significant bowel damage is very low, so I'll take my chances. Obviously my highest priority is to get my cancer sorted!

Oh well...

Chris

User

Posted 11 Jan 2019 at 15:24

My oncologist here in Coventry sniffed when I mentioned SpaceOar to him, (before my prostate surgery), dismissively saying ‘We don’t offer that here’, without any further elaboration.

Well, it’s not his bowel or bladder likely to be perforated if things don’t go to plan.

I hope your treatment goes to plan, and enjoy your holiday.

Best of luck.

Cheers, John.

User

Posted 18 Jan 2019 at 00:52

I had SpaceOar treatment one month before my seed implant. I was my doctor's first patient. I had found out about Spaceoar from my own research and decided I wanted it to reduce the side effects of the radiation. Ask my doctor about it and he had also been talking to the SpaceOar people. The procedure was done in his office with a SpaceOar Rep and another Urologist selling/demoing new Ultrasound Machine. The procedure isn't that long. But hope the shots used to numb the area works better for others than me. Anyway the SpaceOar went in with no problems. Sore for a few days but not bad and could feel a little pressure on the inside for about 3 or 4 days, no pain from SpaceOar. When I had the seeds implanted the members of the team were impressed with the way the Prostate and Rectum were separated. It's been four weeks and the one thing that doesn't have pain is my rectum.

I live in the US and have Medicare HMO. I checked before treatment and it was covered. However, when the doctor billed for the SpaceOar the HMO denied payment. Doctor office has resubmitted the bill. You can watch the procedure on YouTube.

Chris the SpaceOar website has a list of doctors that perform the procedure. Maybe you can a different doctor in just inject the SpaceOar.

Johnny

User

Posted 26 Feb 2019 at 17:51

I had SpaceOAR gel “installed” on 14th Feb (such a treat for Valentine’s Day!, not). My surgeon used a general anaesthetic, he wasn’t at all keen on the “local” idea when I asked how it would be done, but I guess for some patients that might be the preferable or only option depending on other health issues.

I’m due to start radiotherapy tomorrow.

I had MRI and CT scans after the insertion of the spacer. This, my 3rd, MRI is apparently to check that the spacer is in the correct place - it doesn’t show up on the CT apparently. The CT is for planning of the therapy. I think I have those the right way around. No pain or discomfort to mention immediately after the procedure, but some discomfort at various points during the last week which seems to relate to fullness of bowl and or bladder. Seems to be easing in the last 24hours anyway. Will ask the oncologist about it this evening. It never got beyond what 2 paracetamol could cope with.

I have private health insurance from work, but I was told by the onco that they will not pay for the SpaceOAR; however the radiotherapy provider do pay for it as part of the deal apparently. Either way, it’s in! The radiologist told me they have been doing it for all of their prostate patients for the last 5 or so months.

User

Posted 26 Feb 2019 at 19:36

Interesting! Where are you being treated?

Chris

User

Posted 26 Feb 2019 at 20:44

Radiotherapy is happening in Windsor. The service provider company in question was linked to by an earlier poster (Lyn) in this thread.

User

Posted 26 Feb 2019 at 22:09

Barry

User

Posted 14 Mar 2019 at 08:30

Quick update. One month today since SpaceOAR insertion. All discomfort gone.

Revelation: cranberry juice!

I still had some small discomfort remaining when I went to pee. Radiologist suggested “try drinking cranberry juice”. Either I am the most suggestible guy ever, or lucky timing, or, Cranberry Juice is magic! Drank a 250ml glass of said magic fluid with my dinner last night. Yes, it is a bit diuretic! But this morning, no discomfort! Hoorah. Seems unbelievable. Only time will tell.

Off for my 12th “fraction” today.

User

Posted 14 Mar 2019 at 08:34

A "burning" sensation while peeing is an extremely common side-effect of RT and is basically caused by the radiation irritating the bladder. You may find that cutting out caffeine helps.

Hope your treatment continues to go well. I've now completed 22 out of 32 fractions and, touch wood, no sign of any diarrhoea thus far.

Cheers,

Chris

User

Posted 16 Mar 2019 at 16:11

Great to hear that you’re making good progress Chris. I’m a little way behind you at 13/37 of my RT complete. The stinging sensation has been there since two days after the SpaceOAR was inserted. But it could now be down to the radiotherapy. The 2nd suggestion was Ibuprofen, but so far I’ve stayed off that.

Like you, so far no diaorhoea but occasional mucus with the ’gas’, which keeps one guessing! As it happens, my caffeine intake is substantially reduced at the moment as part of my bid to manage the fluid balance. I don’t need anything extra stimulating the kidneys when I am trying to hang on to just the right amount at the right time.

Don’t want to speak too soon/brag/make you jealous, but so far I’m only having to get up once a night. I can only sympathise.

I had a session of Relaxation therapy last week courtesy of www.pennybrohn.org.uk. I went in somewhat sceptical, but now I can’t wait to try it again! Highly recommended.

User

Posted 16 Mar 2019 at 17:01

Glad to hear you’re doing so well. My nighttime situation has improved, I’m happy to say. I only had to get up twice last night, which is a great improvement!

All the best,

Chris

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